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INFLAMMATORY BOWEL DISEASE (IBD) (Chronicity (Disturbed architecture…
INFLAMMATORY BOWEL DISEASE (IBD)
Most common diseases that present in GI clinics
Crohn disease (CD) and Ulcerative colitis (UC) are idiopathic chronic relapsing inflammatory disorders
Microscopic picture of IBD More common and severe in UC
F>M, White>Black. > in Jews
more prevalent in North America, Northern Europe, and Australia (less in
Africa and Asia). Present worldwide
Age: Adolescence or young adults
Activity
Crypt abscesses
Ulceration with
exudation
Cryptitis
Mucous cell depletion
No single test is diagnostic
They differ inThe distribution of the affected sites and their morphological expression
UC>CD
CD is associated with
HLA-DR7 and DQ4 alleles
IL-23 receptor (IL-23R) gene
Mutation in NOD2 gene (CARD15) which is expressed by paneth cells & encodes an intracellular sensor of bacteria
UC is associated with
HLA-DRB1 & IL-23 receptor (IL-23R) gene
Chronicity
Disturbed architecture
Crypt branching
Crypt atrophy
Crypt disarray
Duplication of muscularis
mucosa
Paneth cell metaplasia
Basal cell plasmacytosis
Mucosal atrophy (late)
more common and severe in UC
lamina propria is expanded byinflammatory cells
Triggering by normal microbial flora
Genetic Susceptibility.
Abnormal immune response
self-amplifying cycle of inflammation
increase tight junction permeability